Merit Healthcare Ltd

Updated 17 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 27 June 2023 and ended on 7 July 2023. We visited the office location on 27 June 2023 and 7 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 1 person who used the service, 7 relatives, the registered manager and 11 staff. We reviewed a range of records. This included 5 people’s care and medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed. We received feedback from 4 health and social care professionals who had contact with the service.

Updated 17 August 2023

About the service

Merit Healthcare Ltd is a domiciliary care agency providing personal care to people in their own home. At the time of our inspection there were 56 people receiving personal care from the service.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Following the last inspection, the provider had taken action to address the breaches of regulation and improve the service. However, further action was needed to ensure improvements were sustained and to improve engagement with staff and professionals.

The management team did not always communicate effectively with staff and health and social care professionals or create a culture that empowered staff. The majority of staff we received feedback from did not feel supported or valued by the management team. Some professionals felt the service worked well with them to meet people’s needs. Other professionals felt communication with the management team was not always effective, which had resulted in delays and inconsistencies.

People felt safe receiving care from staff. The provider had taken action to keep people safe and respond to concerns raised. There were effective systems to protect people from the risk of abuse.

People were supported to take medicines safely and staff sought advice from health and social care services when necessary. Staff kept good records of the medicines support they provided to people.

Staff had a good understanding of the support people needed and how to manage any risks they faced. Staff supported people to do as much for themselves as possible and maintain their independence.

The provider thoroughly checked staff before they started providing care for people. People said staff had the skills and knowledge to meet their needs.

The provider had established systems to monitor the quality of service provided and make improvements where needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 August 2021). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out a focused inspection of this service on 13 July 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care, good governance, notification of incidents and employment checks.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Merit Healthcare Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.